Evidence Based Clinical Practice
Evidence Based Clinical Practice or EBCP is an approach to improving the effectiveness of clinical healthcare that is based on the seminal work of Dr. David Sackett and colleagues in the United Kingdom. Stated most simply, EBCP is combining judgments about the best available experimental evidence along with clinical experience and the patient's desires, to improve the outcome in each individual case. In other words, it is the addition of scientifically validated findings to one's clinical expertise: a logical enhancement to advance the quality of patient care.
I was struck at last year's British Association of P&O meeting at how well accepted this notion was among the attendees, and how many of the presentations were based on EBCP principles. I had exactly the same impression last month at the Swedish national meeting. This seems to be an area where US practice is lagging behind our European colleagues, as we remain almost exclusively focused on sharing subjective clinical experiences.
Please note that clinical experience is still of critical importance, and it will remain the foundation for our profession. But, experience alone is a painstakingly slow method for learning since it takes a lifetime of practice to become truly expert. Adding the insights from valid clinical research can amplify the effectiveness of clinical experience, and thus advanced patient care more rapidly.
There are a number of sites on the Internet with information about EBCP. One of the most comprehensive URLs is www.shef.ac.uk/~scharr/ir/core.html, where you can find a virtual library of links to literally dozens of articles on all aspects of Evidence Based Practice. In addition to basic introductory material, there are specific links on such topics as:
- How to read a scientific paper
- Basic statistics for clinicians
- Understanding controlled trials
- Getting research into practice
One of the best introductions to this concept is Dr. Sackett's paper titled Evidence-Based Medicine: What It Is and What It Isn't, at http://cebm.jr2.ox.ac.uk/ebmisisnt.html. The University College Dublin has posted a good basic Evidence-Based Practice Handbook online that introduces the notion of the "Critically Appraised Topic" at http://astaines2.ucd.ie/Teaching/Topics/Evidence%20Based%20Practice/EBP_handbook.html. The CAT is an example of a brief, evidence based review that is much easier than a full blown systematic review of all pertinent literature.
For a more formal introduction to the topic, there is a free distance learning course online at http://info.ex.ac.uk/stloyes/ebpweb.htm. This course is specifically geared toward allied health personnel including nurses, so it is more relevant to prosthetic and orthotic interests than some of the physician oriented programs. The self-directed tutorial at www.intensivecare.com/Tutorial.html seemed a bit more involved to me, but some readers may appreciate the depth that it offers.
I don't see EBCP "taking over the world" in the near term, but do see this approach becoming an increasingly important force in practice, as the scope and quality of P&O research improves in the coming decades. CPOs who plan to be practicing ten years or more from now should start investigating this area, so they can "see" what is coming. And, I believe that the basic educational programs should expose all their students to the principles of EBCP starting right now, since they will make the future of the profession as well as live in it for decades to come.
For another look at EBCP, go to the recent article in the O&P Business News by Judy Otto: Assessing the Relevance & Value of Clinical Research Studies
|
EBCP
Dear Mr.Michael,
I thank you for 'eyeopener' coments on this subject. Your discussion has led us to grasp this subject at the earliest. May I inform you that your given website of Univ. college Dublin's on-line Hand Book with a 'CAT' revie... read more
|
|
EBCP
Hi John
This reminds me of ISO 9000 standards it has lots of paperwork but no meat. Otto Bock, I have notice since they implemented these standards they have had a few things that has broken on us. (Tube adaptors) I see that their focus ha... read more
|
|
|
